A Simple Guide to Parathyroid Disorders, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Parathyroid Disorders, Diagnosis and Treatment and Related Diseases

The 4 parathyroid glands, which are located at the back of thyroid in the neck, constantly monitor and control the amount of calcium, phosphorus and magnesium circulating in the blood.

Hyperparathyroidism:

Four little grains of parathyroid glands
At the back of the butterfly shaped Thyroid Gland
They all produce a bit of parathyroid hormone
To regulate the calcium in the blood and bone

But when the glands produce too much
And one of the gland suddenly become enlarged
The gland really makes me suffer all the weakness and pain
From the loss of calcium accumulated in the bones in vain

Calcium and phosphorus combine to make calcium phosphate.
That material gives hardness and strength to bones and dental plate
Calcium is also needed to help blood to clot after an injury.
It is also required for muscles and nerves to work properly

Phosphorus works with calcium to do these jobs.
Excess parathyroid hormone will cause the phosphorus and energy to drop
No medicine has been known to cure this wayward gland.
I am afraid that only the gland’s removal will be the only end

-An original poem by Kenneth Kee

Hypoparathyroidism

Four little grains of parathyroid glands
At the back of the butterfly shaped Thyroid Gland
They all produce a bit of parathyroid hormone
To regulate the calcium in the blood and bone

But when they produce too little parathyroid hormonally
Or all of them suddenly become removed accidentally
They really make us suffer all the cramps and pain
From the drop in blood calcium accumulated in vain

Calcium and phosphorus combine to make calcium phosphate.
That material gives hardness and strength to bones and dental plate
Calcium is also needed to help blood to clot after an injury.
It is also required for muscles and nerves to work properly

Phosphorus works with calcium to do these jobs.
Without parathyroid hormone, calcium from the body is robbed
No medicine has been known to cure this wayward gland.
The only treatment is by giving calcium supplement

-An original poem by Kenneth Kee

Calcium-sensing receptors of parathyroid cells react to serum calcium level and change with higher release or suppression of PTH.

PTH activates bone resorption which raises serum calcium and phosphorus.

In the kidney, PTH activates reabsorption of calcium and stimulates phosphorus excretion.

PTH also transform 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D in the kidneys, which then raises intestinal transport of calcium and phosphorus.

Parathyroid disorders often present with serum calcium abnormalities.

Rarely, patients can manifest with a neck mass.

When the level of these minerals increase or decrease below normal, these 4 tiny glands adjust the volume of PTH they secrete.

When more of this hormone is circulating, the bones release additional calcium into the blood.

In contrast, when the parathyroid secretes fewer hormones, the bones give up less calcium.

Vitamin D levels are also affected.

This vital balance can get interrupted when the parathyroid glands malfunction, as a result of a disease, injury or another cause.

Treatment is normally removal of the parathyroid glands in hyperparathyroidism and parathyroid tumors or supplements of calcium and vitamin D in hypoparathyroidism.

TABLE OF CONTENT
Introduction
Chapter 1 Parathyroid Disorders
Chapter 2 Understanding Parathyroid Disorders
Chapter 3 Hyperparathyroidism
Chapter 4 Hypoparathyroidism
Chapter 5 Parathyroid Adenoma
Chapter 6 Parathyroid Cancer
Chapter 7 Pseudohypoparathyroidism
Chapter 8 Life and Death of Parathyroid Cell
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Jul 18, 2021
• ISBN: 9781005160814

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Parathyroid Disorders,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2021 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Parathyroid Disorders, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Parathyroid Disorders)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring you the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Parathyroid Disorders

Four little grains of parathyroid glands

At the back of the butterfly shaped Thyroid Gland

They all produce a bit of parathyroid hormone

To regulate the calcium in the blood and bone

But when the glands produce too much

And one of the gland suddenly become enlarged

The gland really makes me suffer all the weakness and pain

From the loss of calcium accumulated in the bones in vain

Calcium and phosphorus combine to make calcium phosphate.

That material gives hardness and strength to bones and dental plate

Calcium is also needed to help blood to clot after an injury.

It is also required for muscles and nerves to work properly

Phosphorus works with calcium to do these jobs.

Excess parathyroid hormone will cause the phosphorus and energy to drop

No medicine has been known to cure this wayward gland.

I am afraid that only the gland’s removal will be the only end

-An original poem by Kenneth Kee

What are Parathyroid Disorders?

Disorders of the parathyroid glands most often present with abnormalities of serum calcium.

Patients with primary hyperparathyroidism, the most frequent cause of hypercalcemia in outpatients, are often:

1. Asymptomatic or may have:

2. Bone disease,

3. Nephrolithiasis, or

4. Neuromuscular symptoms.

Patients with chronic kidney disease may produce secondary hyperparathyroidism with consequential chronic kidney disease-mineral and bone disorder.

Hypoparathyroidism most often happens after neck surgery.

It can also be produced by autoimmune destruction of the glands and other less frequent problems.

Evaluation of patients with abnormal serum calcium levels involves:

1. A history and physical examination;

2. Repeat measurement of serum calcium level; and

3. Measurement of creatinine, magnesium, vitamin D, and parathyroid hormone levels.

The best treatment for symptomatic primary hyperparathyroidism is parathyroidectomy.

Patients with primary hyperparathyroidism and symptoms or signs should go through surgical removal of their parathyroid glands.

Patients with primary hyperparathyroidism who do not go through parathyroidectomy should have serum calcium and creatinine levels measured annually, and 3-site (i.e., hip, spine, and forearm) bone density measurement every 1 to 2 years

Treatment of asymptomatic primary hyperparathyroidism involves:

1. Monitoring symptoms;

2. Serum calcium and creatinine levels; and

3. Bone mineral density.

Patients with hypoparathyroidism need close monitoring and vitamin D (e.g., calcitriol) replacement.

Family members of a patient with multiple endocrine neoplasia type 2 should be investigated for the patient's specific genetic mutation.

The 4 parathyroid glands, sited posterior to the thyroid gland, control calcium homeostasis through release of parathyroid hormone (PTH).

Pathophysiology

The parathyroid glands react to low serum calcium levels by secreting PTH, which is an 84-amino acid peptide.

PTH raises serum calcium levels through direct action on bone and the kidneys.

It activates osteoclasts to resorb bone and mobilize calcium into the blood.

In the kidneys, PTH functions to reduce calcium clearance and activates synthesis of 1,25-dihydroxyvitamin D, which stimulates calcium absorption in the gastrointestinal tract